{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:20:20Z","timestamp":1753888820814,"version":"3.41.2"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T00:00:00Z","timestamp":1725580800000},"content-version":"vor","delay-in-days":249,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Transplantation"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Plasma cell\u2010rich acute rejection (PCAR), a relatively rare subtype of acute allograft rejection, is usually associated with a significantly lower treatment response rate and a higher graft failure rate. PCAR is characterized by the presence of more than 10% of plasma cells out of all graft infiltrating cells, with approximately 40%\u201360% of PCAR resulting in graft failure within a year. Currently, there is no gold standard for the effective treatment of PCAR. This case report demonstrates the potential treatment effect of bortezomib in PCAR. A 37\u2010year\u2010old woman with reflux nephropathy received a kidney transplant from a brain\u2010dead kidney donor. The patient presented with an acute kidney injury with a serum creatinine level over 4\u2009mg\/dL 4 months after the surgery. The allograft biopsy showed acute T cell\u2013mediated rejection (TCMR), Grade IIA, plasma cell\u2010rich variant. There were diffuse polyclonal plasma cells infiltrating the renal parenchyma with marked tubulitis and focal endarteritis. She received a methylprednisolone pulse of 500\u2009mg daily x3, followed by thymoglobulin (rATG) at 4.2\u2009mg\/kg. However, a repeated biopsy after 2 months showed persistent plasma cells infiltrate with increased interstitial fibrosis with tubular atrophy. Then, the patient was given one cycle of bortezomib with a total of four subcutaneous injections and continued immunosuppressants of tacrolimus, mycophenolate mofetil, and prednisone. Following the treatment, the patient\u2019s serum creatinine level trended down to 2\u2009mg\/dL, and a second repeat biopsy after 4 months showed a significant treatment effect with complete resolution of interstitial inflammation and decreased chronicity. Bortezomib is a proteasome inhibitor that prevents cell proliferation by inducing apoptosis in plasma cells and has shown great promise as a therapeutic agent for multiple myeloma. Our case suggests that bortezomib can also be used as a potential therapeutic intervention for patients with PCAR.<\/jats:p>","DOI":"10.1155\/2024\/9226321","type":"journal-article","created":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T10:36:39Z","timestamp":1725618999000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Successful Treatment of Plasma Cell\u2010Rich Acute Rejection Using Bortezomib: A Case Report"],"prefix":"10.1155","volume":"2024","author":[{"given":"Sara","family":"Hashemi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reut","family":"Hod-Dvorai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Tong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8838-5969","authenticated-orcid":false,"given":"Liye","family":"Suo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,6]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000215014.40595.ab"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002366"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199909270-00011"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002041"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.4103\/0971-4065.98753"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.17179\/excli2022-5653"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.6002\/ect.2017.0154"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2019.02.038"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.4103\/1319-2442.335451"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13500"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000030493"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-022-01332-x"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2400763"}],"container-title":["Case Reports in Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2024\/9226321","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T10:36:43Z","timestamp":1725619003000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2024\/9226321"}},"subtitle":[],"editor":[{"given":"Kiran","family":"Upadhyay","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1155\/2024\/9226321"],"URL":"https:\/\/doi.org\/10.1155\/2024\/9226321","archive":["Portico"],"relation":{},"ISSN":["2090-6943","2090-6951"],"issn-type":[{"type":"print","value":"2090-6943"},{"type":"electronic","value":"2090-6951"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2024-06-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"9226321"}}